Abstract: Objective　To analyze the genotype of carbapenemase resistance genes and their genetic homology in multidrug-resistant Acinetobacter baumannii, and to provide a theoretical basis for guiding the rational use of antibiotics and controlling the prevalence of nosocomial infections. Methods A total of 83 multidrug-resistant Acinetobacter baumannii isolated from patients in the intensive care unit (ICU) and environmental specimens in the Sixth People's Hospital of Nantong from July 2020 to December 2021 were collected. The bacteria were identified and subjected to drug sensitivity tests using the BioMérieux DL96-Ⅱ automatic bacterial identification susceptibility system. The carbapenemase-related drug resistance gene types were detected using the polymerase chain reaction (PCR) method, and clones were analyzed by pulsed field gel electrophoresis (PFGE). Results The types of 83 ICU Acinetobacter baumannii specimens include sputum (43 strains), broncholavage fluid (20 strains), and surfaces of objects such as ventilators (20 strains). The resistance rates of all strains to imipenem, tetracycline, gentamicin, amikacin and ciprofloxacin were 100%, 32.5%, 38.6%, 41.0% and 77.1% respecitively, while the resistance rates to others such as ticarcillin and clavulanate were greater than 95%. All strains carried were detected to carry OXA-23 and OXA-51 genes, while OXA-24, OXA-58, IMP-1, VIM, IMP-4, SIM and NDM-1 resistance genes were all negative. PFGE homology analysis confirmed that 83 strains of Acinetobacter baumannii, with counts of 12, 18, 12, 13, 10, 6, 7, 5 respectively, mainly A, B, C, D, E clones, the rest were sporadic clones. Conclusions The carbapenem resistant Acinetobacter baumannii isolated from our ICU are widely drug-resistant to commonly used antimicrobial drugs, with B clone strain being the major prevalent strain. Carrying OXA-23 and OXA-51 genes may be an important reason for the resistance of Acinetobacter baumannii to carbapenem antibiotics in our ICU. Rational use of antimicrobial drugs, enhanced monitoring of bacterial resistance, and effective control of the generation and further spread of drug-resistant strains should be emphasized.

purpose To investigate the release properties of gatifloxacin in situ pH-sensitive gel in vitro.Methods The improved paddle method and the membraneless model were applied in assessing the drug release behavior.Results The gel erosion and drug release were increased with the increase of surface area and shaking frequency.The cumulative quantities of gel erosion were well correlated with the cumulative release of drug loaded in the gel.Conclusion Gatifloxacin was released from in situ pH-sensitive gel with zero-order kinetics characters,and drug release was mainly controlled by gel erosion.

Objective To study the effect of the deferoxamine mesylate on the prognosis of patients with intracerebral hemorrhage(ICH) after one year. Methods From February 2013 to May 2014,spontaneous ICH patients diagnosed by computed tomography ( CT ) within 18 hours of onset in Mancheng District Hospital of Baoding were evaluated. Patients were randomly divided into experimental group and control group. The treatment of the two groups was similar except that the experimental group received deferoxamine mesylate. Patients were e?valuated by CT and neurology scale( NIHSS scale,GCS scale) at the time of admission and followed up for the first year by the RANKIN( mRS) scale. All clinical data of the two groups were compared. Results Forty?two patients were included in the study, including 21 cases in the experimental group and 21 cases in the control group,there was no significant difference in baseline data between the two groups at admission. There were 6 pa?tients with mRS ≥3 in the experimental group, and 6 patients with mRS ≥3 in the control group after one year. There was no statistically significant difference in the distribution of mRS score between the two groups after one year admission( P=1. 000) . Conclusion There may be no helpful on the prognosis of patients with intrace?rebral hemorrhage by intravenous infusion of deferoxamine mesylate,the further study is needed.

Objective To investigate the influences of different mechanical ventilation modes on ventilator?induced diaphragm dysfunction (VIDD). Methods The patients received invasive mechanical ventilation in our ICU after lower abdomen surgery were enrolled into 3 groups according to different ventilation modes. The data of the 3 groups were analyzed. According to the offline results, patients were divided into two groups, the success of weaning as the dependent variable, the clinical indicators with statistical significance as the independent variable, the Logistic regression analysis was performed to analyze the ventilator weaning. Results The mechanical ventilation time, 48 h reintubation rate and the length of ICU stay in the A/C mode group were significantly higher than those in the SIMV mode group and the PSV mode group. The weaning success rate in the A/C mode group was significantly lower than that in the SIMV mode group and the PSV mode group, with significant difference (P<0.05). Weaning success group and weaning failure group had significant differences in the proportion of three ventilation modes (P < 0.05). With weaning as dependent variable, APACHE Ⅱ score, ALB and ventilation mode as independent variables, logistic regression analysis was performed using the enter method. APACHE Ⅱ and ventilation mode were independent influencing factors for weaning. Conclusion Compared with the A/C mode, the SIMV mode and the PSV mode have less influence on VIDD and high weaning success rate in the mechanical ventilation process of patients post?lower abdomen surgery. No significant difference was found between the SIMV mode and the PSV mode in their influence on weaning.

Objective To investigate the prevalence of chronic kidney disease (CKD) and its risk factors in Chinese elderly persons.Methods All of the people who underwent physical examination and treatment in the geriatric department of Beijing Hospital during January 2004 to January 2007 were included in the study.Age, body height, body mass index and blood pressure were recorded.Bloody urine was ascertained by phase-contrast microscope, and urine protein was measured by dipstick test.The hemoglobulin, serum eretinine, blood urea nitrogen, blood lipid and serum uric acid were measured by autobiochemical analyzer.HbsAg was checked by enzyme-linked immunosorbent assay (ELISA).Glomerular filtration rate (GFR) was estimated by Crockeroft-Gauh equation and abbreviated MDRD equation.Binary logistic regression analysis was used to test the risk factors for proteinuria and CKD.Results The prevalence of proteinuria was 4.9% in 1082 elderly persons.And 47.23% of the elderly suffered from decreased renal function.The morbidity of CKD was 48.43%.Binary logistic regression analysis showed that diabetes(OR= 2.257) and microscopic hematuria(OR=5.324) were the risk factors of proteinuria (both P<0.05).And the risk factors for CKD were hypertension(OR= 1.459), coronary arth'erosclerotic heart disease(OR=3.290), chronic obstructive lung diseases(OR=2.094), malignant tumor(OR=2.072), hyperuricemia(OR= 1.928),anemia(OR=8.122)and hematuria( OR= 1.604) (all P<0.05).Conclusions The morbidity of CKD in Chinese elderly persons was 48.43%.And the related risk factors were diabetes,hypertension, hyperuricemia, coronary artherosclerotic heart disease and chronic obstructive lung disease.

Objective To explore the effects of acupuncture combined with rehabilitation training on neural function,motor function and quality of life in patients with cerebral apoplexy.Methods From September 2015 to September 2017,ninety-four patients with stroke rehabilitation in Zhejiang Provincial Taizhou Hospital were selected and divided into observation group and control group according to random number table ,with 47 cases in each group. The control group was treated with rehabilitation training ,and the observation group was treated with acupuncture and moxibustion on the basis of the control group.The two groups were treated for 8 weeks.The changes of nerve function , motor function,balance function,daily living ability and quality of life before and after treatment were compared between the two groups.Results After 4 weeks and 8 weeks of treatment,the NIHSS score,FMA score,BBS score and BI index score of the two groups decreased compared with before treatment (observation group:t＝21.481,36.045,10.726, 21.961,14.040,26.501,25.827,42.266;control group:t＝12.011,20.519,5.527,15.644,7.201,18.719,15.836, 29.852,all P＜0.05),and at 8 weeks after treatment,the NIHSS score,FMA score,BBS score and BI index score decreased compared with those at 4 weeks after treatment(observation group:t＝17.791,11.558,12.486,13.867;control group:t＝10.352,9.721,11.028,11.129,all P＜0.05).The NIHSS scores of the observation group after 4 weeks and 8 weeks of treatment were lower than those of the control group [(8.94 ±1.02) points vs.(10.56 ± 1.20)points,(5.61 ±0.78)points vs.(8.23 ±0.97)points,t＝7.052,14.431,all P＜0.05].The FMA scores of the observation group after 4 weeks and 8 weeks of treatment were lower than those of the control group [(18.54 ± 3.24)points vs.(15.03 ±2.71)points,(27.39 ±4.13)points vs.(21.03 ±3.25)points,t＝5.697,8.297,all P＜0.05].The BBS scores of the observation group after 4 weeks and 8 weeks of treatment were lower than those of the control group[(35.27 ±3.67)points vs.(31.09 ±3.15)points,(45.86 ±4.51)points vs.(38.98 ±3.76)points,t＝5.925,8.033,all P＜0.05].The BI index scores in the observation group after 4 weeks and 8 weeks of treatment were lower than those in the control group[(63.26 ±5.68)points vs.(56.18 ±6.02)points,(79.21 ±5.47)points vs.(68.77 ±4.89)points,t＝5.865,9.755,all P＜0.05].Conclusion Acupuncture combined with rehabilitation training can improve the neurological function ,motor function and quality of life of patients with cerebral apoplexy.

To explore the relationship between brachial ankle artery pulse wave velocity of the (baPWV) in different estimation GFR (eGFR) groups and atherosclerosis.In 2010,2012 and 2014,eGFR and baPWV were detected in 1 427 healthy persons.As eGFR level decreased,baPWV increased accordingly with higher proportion of baPWV ≥1 400 cm/s.The percentage of eGFR lower than 60 ml · min-1 · 1.73 m-2 was similar in subgroups with different baPWV.However,the proportion of eGFR reduction ≥ 30％ decreased according to the elevation of baPWV.Multivariate logistic regression analysis indicated the lower the eGFR,the higher the risk of atherosclerosis.Low eGFR is an independent risk factor for atherosclerosis.

Purpose The aim of this study is to define molecular sub-healthy status among individuals attending routine physical examination.Methods This study examined 8 blood tumor markers among 5 825 healthy individuals.Results (1) Differences in levels of tumor markers were observed between males and females.(2) Elevated CA72-4 levels were seen in 16.05％ of individuals in both sexes.(3) More males had elevated levels of CEA and CYFRA21-1.Among the individuals with elevated levels of tumor markers,most were clustered in the prime age group of 41 to 50 years.Conclusion This is the first large-sample survey in healthy Han population in Xinjiang,which found elevated levels of all 8 markers tested with varying rates.Accordingly,this study proposes for the first time a concept of molecular sub-healthy status and a strategy of early tumor screening at molecular level.The molecular sub-healthy status may be an early warning sign for potential cancers,which should draw attention by preventive public health policies.

Objective To measure the organ weights , physiological and biochemical parameters and immune cells of NOD/SCID mice.Methods Mice at five and ten weeks of age were selected .The organ weights, blood physiological and biochemical parameters were observed .The percentages of CD 3+, CD4+, CD8+, CD19+, B220+, NK1.1+, and CD11b+were checked by FCM in NOD/SCID mice at six week of age in terms of its T , B lymphocyte function and NK cell activity.Results Among the same sex group of NOD/SCID mice, the weights of kidney, liver, heart and lung, and the blood physiological indexes of RBC , HGB, HCT, MCV, MCH, RDW, and the blood biochemical indexes of TP , ALB, ALP, CHO, TBIL show significant difference between 5 and 10 weeks.At the same age, HCT, GLOB, A/G, CHO, TG, TBIL and the UN are significantly different between male and female NOD /SCID mice.NOD/SCID mice lack T cells (0.37 ±0.26)%、CD4+T cells (0.35 ±0.13)%、CD8 +T cells (0.47 ±0.10)%、CD19+B cells (0.13 ± 0.05)%、B220+B cells (1.20 ±0.44)%.The percentage of NK cells is (6.90 ±0.82)%, and the percentage of granulocytes is (47.88 ±15.54)%.Conclusions The study indicates that NOD/SCID mice show the deficiency of T , B and NK cells function .The organ weights , blood physiological and biochemical parameters are affected by age and gender . The studied parameters of NOD/SCID mice are similar with the same strain in other countries .

Objective To explore the anatomic character of brachial plexus nerve by ultrasonography,and provide a basis for ultrasound-guided brachial plexus block.Methods Twenty-four healthy volunteers were chosen for high-frequency sonography examination,the features of brachial plexus distributions were studied in the axilla location and the interscalene location.Results Brachial plexus of all the 24 cases were detected.At the axilla level,main braches of brachial plexus nerves were very close to the axillary artery.At the interscalene level,the brachial plexus was consistently found between the scalenus anterior and medius muscles in the interscalene groove.Conclusions Using high-frequency sonography,the main braches of brachial plexus can be observed clearly.